Usefulness of cell ratios and the derived neutrophil-to-lymphocyte ratio in the diagnosis of pediatric acute appendicitis.

J C Moreno-Alfonso, A Molina Caballero, A Pérez Martínez
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Abstract

Objective: To analyze the accuracy of cell ratios in the diagnosis of pediatric acute appendicitis while introducing a new one -the derived neutrophil-to-lymphocyte ratio (dNLR).

Materials and methods: An observational, retrospective study of patients aged 0-15 years old diagnosed with acute appendicitis (AA) and with non-surgical abdominal pain (AP) treated in our institution from 2021 to 2022 was carried out. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and dNLR were compared between groups.

Results: 98 AA patients (30% of whom were female; age: 10 ± 3.3 years) and 97 AP patients (53% of whom were male; age: 9.3 ± 3.7 years) were included. NLR, MLR, PLR, and dNLR values were higher in AA patients than in AP patients: 9.6 IQR (interquartile range) 9.5 vs. 3.3 IQR 5.3: p< 0.0001; 0.7 IQR 0.6 vs. 0.46 IQR 0.7: p< 0.023; 199.8 IQR 163.9 vs. 134.0 IQR 129.2: p< 0.0001; and 5.29 IQR 3.9 vs. 2.39 IQR 2.7; p< 0.0001, respectively. Sensitivity, specificity, positive-negative predictive value, area under the ROC curve, and dNLR cut-off point for AA diagnosis were 70%, 78%, 77-72%, 0.811, and 3.98, respectively.

Conclusions: Cell ratios are useful and cost-effective inflammatory parameters in the diagnosis of pediatric acute appendicitis. The results of this study suggest dNLR has the greatest clinical accuracy.

细胞比率和衍生中性粒细胞与淋巴细胞比率在诊断小儿急性阑尾炎中的实用性。
摘要分析细胞比值在诊断小儿急性阑尾炎中的准确性,同时引入一种新的细胞比值--衍生中性粒细胞与淋巴细胞比值(dNLR):我院对2021年至2022年期间诊断为急性阑尾炎(AA)和非手术腹痛(AP)的0-15岁患者进行了一项观察性、回顾性研究。比较了各组间的中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR)和dNLR:共纳入 98 名 AA 患者(其中 30% 为女性;年龄:10 ± 3.3 岁)和 97 名 AP 患者(其中 53% 为男性;年龄:9.3 ± 3.7 岁)。AA患者的NLR、MLR、PLR和dNLR值均高于AP患者:9.6 IQR(四分位数间距)9.5 vs. 3.3 IQR 5.3:P结论:细胞比率是诊断小儿急性阑尾炎的有用且经济有效的炎症参数。本研究结果表明,dNLR 的临床准确性最高。
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